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No ED cuts its average door-to-doc time from 93 minutes to 20 minutes by accident. The success story at Memorial Hermann Memorial City Medical Center in Houston was the result of discovering a patient flow model at another facility that was superior to theirs, and then continuing to search out additional models to come up with their own system that best addressed their specific needs.
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In February 2008, 12% of the patients who presented to the ED at Gaston Memorial Hospital in Gastonia, NC, left without being treated.
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By implementing a Lean process change that it calls TAPP (Team Assessment Pull Process), the ED leadership in the Children's Healthcare of Atlanta system has realized a 25-minute reduction in median overall turnaround time, from 192 minutes to 167 minutes, excluding its fast track.
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When Sen. Edward M. Kennedy (D-MA) was brought to the ED at Washington (DC) Hospital Center on Jan. 20, 2009, following a seizure, the department was well prepared.
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Acute gastroenteritis in children is not a benign condition. Worldwide, millions of young children continue to die from this treatable condition every year. Fortunately, in developed countries like the United States, deaths are uncommon, but a substantial proportion of pediatric acute care visits and hospitalizations are directly related to the dehydration caused by this condition.
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[Editor's note: This is the second of a two-part series on medical screening examinations (MSEs) performed by emergency nurses. This month, we cover the potential liability risks of nurse-performed MSEs and how to avoid legal problems. Last month, we reported on benefits seen by two EDs that have implemented this practice.]
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When 103 ED patients, 34 ED physicians, and 44 ED nurses were surveyed, they all agreed on one thing: Treating chronic pain in the ED is a "low priority."
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Nearly half of older patients use prescription and over-the-counter (OTC) medications together, says a new study, and one in 25 is at risk for a major potential drug-drug interaction. The researchers also found that 29% of these patients use at least five prescription medications.
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Severely dehydrated children are "in imminent danger" due to cardiovascular collapse, increased acidosis, and metabolic abnormalities, all of which can lead to significant morbidity and in some cases mortality, warns P. Jamil Madati, MD, director of emergency medical services at Rady Children's Hospital in San Diego.
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Knee and ankle injuries are very common in pediatrics. Sports and recreational activities are frequent sources of injury, hence are sources of typical emergency department (ED) visits. Although sprains and contusions frequently occur, it is critical that the unique aspects of the pediatric skeleton and its associated vulnerability are considered. Imaging and treatment are focused on identification of fractures and associated injuries; correct immobilization and appropriate follow-up, based on the injury, are necessary to maximize the outcome for each injury.
